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August 14, 1972

Placing the Pacing Wires

Author Affiliations

Columbia, Tenn

JAMA. 1972;221(7):713. doi:10.1001/jama.1972.03200200059021

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To the Editor.—  As our coronary care unit of seven beds is located on a different floor from the x-ray department, it was quite difficult and potentially hazardous to transport our coronary care patients to the x-ray department for the placement of pacing wires. To avoid this, we passed several pace wires with the use of intra-atrial electrocardiographic monitoring. While this worked well for a fair number of cases, because of artifact and because of patients who had atrial fibrillation, many times this was not successful either.During the past four years, on 42 occasions, the pace wire has been passed by us without either of the two above-mentioned methods, but by a procedure that I term "fishing." This procedure is characterized by putting the pace wire into the basilic vein, preferably with a cut-down method, then turning the pace voltage to 5 to 7 mv, thereby watching the muscle